Provider Demographics
NPI:1841250560
Name:DOWDY, CYNTHIA M (PHD, LPC)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:M
Last Name:DOWDY
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 LAKE BOONE TRL
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-7503
Mailing Address - Country:US
Mailing Address - Phone:919-866-1959
Mailing Address - Fax:919-786-0604
Practice Address - Street 1:4601 LAKE BOONE TRL
Practice Address - Street 2:SUITE 2C
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-7503
Practice Address - Country:US
Practice Address - Phone:919-866-1959
Practice Address - Fax:919-786-0604
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-25
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3694101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC478028OtherVALUE OPTIONS
NC130UAOtherBLUE CROSS BLUE SHIELD
NC6103788Medicaid